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Abstract

Objective: The objective of this study was to determine the occurrence and antimicrobial profile of AmpC ?-
lactamase producing bacteria. Methods: The study was conducted at The DHQ teaching hospital Sargodha and
Allied hospital faisalabad, Pakistan, during September 2016 to June 2017. A total number of 1,914 blood samples
of suspected neonatal septicemia were processed. Isolates were identified using Gram’s staining, API 20E and API
20NE tests. Gram negative isolates were screened for AmpC ?-lactamase production against ceftazidime,
cefotaxime and cefoxitin resistance and confirmed by inhibitor based method. Results: Total number of 54 (8.49%)
Gram positive and 582 (91.5%) Gram negative bacteria were identified. Among Gram negative isolates 141 (22%)
were AmpC producers and found to be 100% resistant to co-amoxiclav, cefoxitin, ceftazidime, cefotaxime,
cefuroxime, cefixime, ceftriaxone, cefpodoxime, gentamicin, amikacin and aztreonam. Less resistance was
observed against cefepime (30.4%), sulbactamcefoperazone (24.8%), piperacillin-tazobactam (10.6%),
ciprofloxacin (20.5%) and meropenem (2.1%). All the isolates were found sensitive to imipenem. The patients
harbored AmpC ?-lactamases were on various interventions in which intravenous line was noted among (51.1%),
naso-gastric tube (37.6%), ambu bag (8.5%), endotracheal tube (3.5%), ventilator (2.1%) and surgery (0.7%).
Conclusion: Extensive use of invasive procedures and third generation cephalosporins should be restricted to
avoid the emergence of AmpC beta-lactamases in neonates.